HomeMy WebLinkAboutBuilding Permit #564 - 157 PLEASANT STREET 3/19/2010 BUILDING PERMIT Of NORTH A
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TOWN OF NORTH ANDOVER cr °: - o�
APPLICATION FOR,PLAN EXAMINATION
Permit NO: Date Received
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Date Issued: .� 1� /� VS CHUS
IMPORTANT: Applicant must complete all items on this page
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LOCATION,;,. f 7 P R S
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PROPERTY OWNER ' l" 14/��� M n�1
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MAP 210 „ PARCEL: ,ZO�N11ti1G DI�T.RICT: x Historic-District Yes no
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7� Machine Shop,Village yes no .
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
Alteration No. of units: Commercial
e a' replacement Assessory Bldg Others:,
Demolition Other
pFioodplait 4Wetlands Watesf�ed Distract
eIIR
Water/Sewer
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DESCRIPTION OF WORK TO BE PREFORMED:
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Identification Please Type or Print Clearly)
OWNER: Name: Alf-14ftL MONTLFlRfl Phone: 5'09-5100JU4
Address:
CONTRACTOR Name: Phone: °
Address. ° °,'
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Supervisor's Con structiori'Licerse: Exp: .Date: °4
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x`Ho:me Improvement License. _ Exp.
, Date: r
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 3D0 FEE: $
Check No.: / < 2 �,: Receipt No.: 0:2 ,F
NOTE: Persons contracting with unregistered contractors do not have access to theuaran II and
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CSw
ignature of.Agent7ne "�S"ignatreof contractor- _
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools ,
Well Tobacco Sales Food Packaging/Sales
Private(septic tank,etc. Permanent Dumpster on Site
THE FOLLOWING.SECTIONS FOR-,OFFICE .USE ONLY
INTERDEPARTMENTAL SIGN OFF = U`FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
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CONSERVATION Reviewed on Signature
COMMENTS
,HEALTH - Reviewed on ,. Signature
Y
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
Located -384 Osgood Street
FIRE DEPARTMENT Tem .�r
p�Dupster orl site yes: }no
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Located:at 124'Win,Street
Fire Department=signaturel�date
COMMENTS `` �x
Dimension
Number of Stories: Total square feet of floor area; based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast-or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
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NOTES and DATA— For department use)
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❑ Notified for pickup - Date
Doc.Building Permit Revised 2010
I
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
Roofing, Siding, Interior Rehabilitation Permits
❑ Building Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy'of Contract
❑ Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
❑ Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (if Applicable)
❑ Copy of Contract
❑ Mass check Energy Compliance Report
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submitted with the building application
Doc:Building Permit Revised 2008
Location
�S 7
No. Dateo
NuoT:�h TOWN OF FORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
ACMuS
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
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2266; 7
.Building Inspector
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No.
A K E dover, Mass.,_J//1_11X e
Ap COCHICMEWICK
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��ADRATED P` P��S
S BOARD OF HEALTH
PERM T T Food/Kitchen
Septic System
THIS CERTIFIES THAT / BUILDING INSPECTOR
.1.............. .. ,..Y. .........
Foundation
has permission to erect........................................ buildings on ....1 ..,...... ,�G "
Rough
to be occupied as........................... �'�.'.�.... ...
��F:. U.. Chimney
provided that the person accepting this permits all i every respect conform to the terms of the application on file in
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final
Buildings in the Town of North Andover.
PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR
Rough
Service
BUI INSPECTOR
Final
Occupancy. Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
Final
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT'
Burner
Street No.
IL—SEE REVERSE SIDE Smoke Det.
NORTH TOWN OF NORTH ANDOVER
OFFICE OF
9 BUILDING DEPARTMENT
1600 Osgood Street Building 20, Suite 2-36
North Andover,Massachusetts 01845
�SSgcHus��
Gerald A.Brown Telephone(978)688-9545
Inspector of Buildings Fax (978)688-9542
HOMEOWNER LICENSE EXEMPTION
BUIDING PERMIT APPLICATION
Please print
DATE: W/o
JOB LOCATION: X97 94e/4 Nr ST
Number Street Address Map/Lot
HOMEOWNER 0149#&- 1' DAWI O 5'08• S(*6--9 2 8i 41-7-72.6-050
Name Home Phone Work Phone
PRESENT MAILING ADDRESS_ /5'7 ei-E454yr 5
moo v6?, /4,4
City Town State Zip Code
The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and
to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner
acts as supervisor)-. State Building (Code Section 108.3.5.1)
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to
be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be
considered a homeowner.
The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other
Applicable codes,by-laws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department
. minimum inspection procedures and requireme and that h /she will comply with said procedures and
requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Revised 7.2009
Form Homeowners Exemption
BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535